Individual
MRS. GEORGIA LEANN FAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
122 5TH AVE S # 122B, EDMONDS, WA 98020-3423
(707) 812-0669
Mailing address
23306 EDMONDS WAY APT G206, EDMONDS, WA 98026-8658
(707) 812-0669
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA61102809
WA
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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